CERTIFICATE OF INSURANCE (148)
Poe & Associates, Inc.
P.O. Box 1348
Tampa, FL 33601
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
INSURED
Don Olson Firestone, Inc.
2021 Sunnydale Boulevard
Clearwater, FL 33515
COMPANY A
L8TER Insurance Company of North America
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
- ,
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY
BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI.
TIONS OF SUCH POLICIES.
TYPE OF INSURANCE
POLICY NUMBER
POliCY EFFECTIVE POLICY EXPIRATION LIABILITY LIMITS IN THOUSANDS
DATE (MM/DDIYY) DATE (MMlDDIYY) EACH AGGREGATE
OCCURRENCE
BODILY
INJURY $ $
11/08/87 11/08/88 PROPERTY
DAMAGE $ $
GENERAL LIABILITY
COMPREHENSIVE FORM
PREMISES/OPERATIONS
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
X PRODUCTS/COMPLETED OPERATIONS
X CONTRACTUAL
X INDEPENDENT COf\:TRACTORS
X BROAD FORM PROPERTY DAMAGE
X PERSONAL INJURY
Dl 16 72 71 1
BI & PD
COMBINED
$1,000
$1 , 000
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV, PASS,)
AlL OWNED AUTOS (OTHER THAN)
PRIV, PASS,
X HIREO AUTOS
X NON-OWNED AUTOS
GARAGE LIABILITY
H00366468
11/08/87
11/08/88
PERSONAL INJURY $
BOOIl Y
INJUAY $
(?fA ?fASON)
BODilY
INJUAY $
(?fA ACCIDENT)
PROPERTY
DAMAGE $
BI & PD
COMBINED $1 000
BI & PD $ 2,000
COMBINED
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
XBC G1 08 49 63 9
11 /08/87
11 /08/88
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
(EACH ACCIDENT)
(DISEASE-POLICY LIMIT)
(DISEASE-EACH EMPLOYEE)
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESlSPECIAL ITEMS
Operations: Firestone Dealer-Tire Sales & Service
City of Clearwater Purchasing Division
P. O. Box 4748
Clearwater, Florida 33518